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As living standards have improved, acute rheumatic fever and rheumatic heart disease have become rare diseases in developed countries . Treatment with antibiotics has also helped to limit the scope of diseases, but less important than the prosperity increase.

Acute rheumatic fever and rheumatic heart disease occur today mainly in developing countries. According to WHO there are at least 15.6 million people have rheumatic heart disease. The incidence is highest in African countries south of Sahara, on the Pacific Islands and the primitive tribes of Australia and New Zealand. Incidence of rheumatoid heart disease increases with age and reaches its highest level in the age group 25-34 years. 233,000 deaths per annum attributed to acute rheumatic fever or rheumatic heart disease.

Acute rheumatic fever is a rare condition among the youngest children, only 5% of cases occur among children under five years, and the condition is almost unknown inchildren under two years. The first episodes of rheumatic fever are most common just before puberty, decreases in late adolescence and is rare among adults older than 35 years. Recurrent episodes are especially frequent among teens and early adulthood.

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